Y P O C T O Central Motor Conduction N Time (CMCT) O D E - - PowerPoint PPT Presentation

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Jan 21, 2024 32 likes •228 views

Y P O C T O Central Motor Conduction N Time (CMCT) O D E S Paula Davila-Prez, M.D., Ph.D. A Tim Morris, Ph.D. E June 2019 L P Y P O Outline C T O Physiological and technical aspects N O Clinical applications

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Central Motor Conduction Time (CMCT)

Paula Davila-Pérez, M.D., Ph.D. Tim Morris, Ph.D. June 2019

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Outline

Physiological and technical aspects
Clinical applications
Hands-on!

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Definition of CMCT

Time taken for neural impulses to travel through central nervous system on their way to the target muscle.

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Spinal Stimulation (b)

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Method 1 Method 2

Kobayashi and Pascual-Leone 2003

F wave + M wave -1 2 peripheral time (ms) =

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Stimulation of the roots: (TMS)

– Excites the roots at foramina

Overestimation of CMCT

– Lower limbs may be difficult to assess

F-Waves method:

– Assumes conduction is normal at proximal segments (Guillain-Barre S.) – Proximal muscles or muscles with no F-waves may be difficult – More accurate – Needs 2 stimulators

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IFCN Guidelines (http://www.ifcn.info/)

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Longer conduction time
Dispersed and more attenuated responses
Low amplitude or no responses

Udupa & Chen. Handbook of Clinical Neurology. 2013

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CMCT and Diseases

Udupa & Chen. Handbook of Clinical Neurology. 2013

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HANDS-ON !

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Cortical Silent Period (cSP)

cSP Conditions:

120% of RMT
<50% of total muscle

contraction The Cortical Silent Period translates GABAB inhibitory cortical processes The initial part of the cSP is thought to reflect spinal inhibition (≈50ms)

Time (ms) Amplitude (mV) TMS Pulse